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Implied consent prior to nursing care procedures

Authors


Helen Aveyard, School of Health Care, Oxford Brookes University, Heritage Gate, Sandy Lane West, Oxford OX4 6LB, UK. E-mail: haveyard@brookes.ac.uk

Abstract

The aim of the paper is to demonstrate the nurses should be wary of relying on the concept of implied consent prior to nursing care procedures.

Rationale.  The difference between a patient who implies consent and who merely complies with a procedure is almost undetectable.

Methods.  An exploratory study, incorporating use of focus groups and critical incident technique to examine the way in which nurses obtain consent prior to nursing care procedures.

Findings.  Many nurses administer care without seeking verbal or written consent, but claim that the patient's consent is implied. However, there is evidence that care is often administered in the absence of information-giving and that this perceived implied consent should more realistically be called compliance. Implied consent is consent for which information is a crucial component. There is evidence that the term implied consent signifies different things to different nurses. Furthermore, even if there is agreement about what constitutes implied consent, in practice, implied consent may be indistinguishable from compliance. Nurses who assume that they have the patient's implied consent, when in reality only have compliance, risk carrying out care procedures without the patient's consent.

Conclusions.  Nurses should be familiar with the principles of implied consent. They should be wary of relying on the use of implied consent prior to nursing care procedures because of the difficulty in distinguishing implied consent and compliance. Nurses should approach all aspects of care-giving with the offer of information. In order to reduce the risk of misinterpretation of a patient's implied consent, they should seek the verbal affirmation of a patient prior to a nursing care procedure. Where nurses rely on the patient's implied consent, they should do so at their own discretion and with full understanding of the meaning of the term.

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